Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Physician ED Claims Reviewer (UM & Coding)

Vytwo

Prosper, TX
  • Remote job

Vytwo seeks a Physician ED Claims Reviewer for a 12-month remote assignment. The clinician will conduct clinical review of claims and UM authorization requests to determine clinical necessity, leveraging CPT/HCPCS coding and managed care expertise. Ideal candidates hold an active US medical license with 3–5 years of emergency department medicine experience or equivalent internal medicine background, and possess strong knowledge of claims processing and medical coding. #J-18808-Ljbffr Vytwo

Vacancy posted 11 hours ago
Similar jobs that could be interesting for youBased on the Remote Physician ED Claims Reviewer (UM & Coding) in Prosper, TX vacancy
  • Vytwo Technologies Inc. seeks a Physician ED Claims Reviewer for a 12-month remote assignment. The role focuses on clinical...  ...and utilization management (UM) authorization requests to determine...  ...and have experience with CPT/HCPCS coding, managed care, and using multiple... 
    Remote job
    Claims

    Vytwo Technologies Inc.

    Prosper, TX
    11 hours ago
  •  ...experienced DRG Clinical Physician Reviewer to join our growing...  ...team. This is a fully remote opportunity for a...  ...improved documentation, coding accuracy, and cost containment...  ...review experience (UM, DRG Validation, or...  ...Validation, CDI, or claims review strongly preferred... 
    Remote work
    Claims
    Full time

    MedReview

    New York, NY
    a month ago
  • $285.23k - $332.26k

     ...Mso Physician Reviewer Burlingame, CA 94010 Overview Salary Range $2...  ...collaborates with healthcare providers, UM team members, and case...  ...process by reviewing denied claims and reconsidering medical...  ...stratification and appropriate coding and documentation based on patient... 
    Claims
    Full time

    North East Medical Services

    Burlingame, CA
    3 days ago
  •  ...Medical Director for review and works closely with...  ...with the treating physician or other providers of...  ...responsible for pricing, coding, researching claims to ensure accurate...  ...multiple areas (i.e. UM and CM). Incumbent is...  ...may be opportunity for remote work within all jobs... 
    Remote work
    Claims
    Contract work
    Work at office

    Capital District Physicians Health Plan Inc

    Jamestown, NY
    5 days ago
  • A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,... 
    Remote job
    Claims
    For contractors
    Monday to Friday
    Flexible hours

    Dane Street

    Washington DC
    1 day ago
  •  ...Job Description Job Description Physician Peer Reviewer – Multiple Specialties in Texas and/or...  ...MEXICO to assist with independent review claims and appeals in any of the following...  ...performing external reviews Job Type Contract Work Location Remote... 
    Remote work
    Claims
    Contract work
    Work experience placement
    Work at office

    Federal Hearings And Appeals

    Wilkes Barre, PA
    1 day ago
  •  ...Claims Reviewer Location: Phoenix AZ 85053 (REMOTE) Duration: 6+ Months Pay Range: $28.00/hr on W2 Shift: Mon Fri 8.00 AM 5 PM PST Job Summary...  ...resolution, audit, and related functions. Applies clinical, coding, and processing knowledge to conduct review of... 
    Remote work
    Claims
    Contract work
    For subcontractor
    Interim role
    Shift work

    Pacer Group

    Phoenix, AZ
    1 day ago
  • $79k - $99.75k

     ...comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules,...  ...on inpatient DRG claims as they compare with medical...  ...medical records such as physician notes, lab tests, images...  ...We foster a hybrid and remote friendly culture, and all... 
    Remote work
    Claims
    Full time
    Work at office
    Local area
    Visa sponsorship
    Flexible hours

    Zelis

    Saint Louis, MO
    4 days ago
  • $248.5k - $373k

     ...together. As part of the Focus Claims Review team at Optum, the Medical...  ...as a liaison between Optum, physicians, and other medical service...  ...hours per week. This can be remote work from home anywhere in...  ...professional claims for correct coding using clinical record... 
    Remote job
    Claims
    Minimum wage
    Part time
    Work experience placement
    Local area
    Work from home

    UnitedHealthcare

    Houston, TX
    2 days ago
  • Trinity Health is seeking a Physician Coding Specialist II in Columbus, Ohio. This position involves assigning surgical and office procedural...  ...codes to patient health information for data retrieval and claims processing. The ideal candidate will possess a high school diploma... 
    Remote job
    Claims
    Work at office

    Trinity Health

    Columbus, OH
    3 days ago
  • $38.02k - $49.43k

     ...File Room (EFR) and RightFax. Reviews invoice documentation to...  ...criteria. Uses established coding procedures to annotate correspondence...  ...Preference: If you are claiming veteran's preference, you MUST...  ...: Cleveland, OH 1 vacancy Remote job No Telework eligible No... 
    Remote work
    Claims
    Permanent employment
    Full time
    Part time
    For contractors
    Work at office
    Relocation
    Relocation package

    Fairweather, LLC

    Cleveland, OH
    1 hour ago
  • $24 per hour

     ...IN-OFFICE - HYBRID - REMOTE POSITIONS AVAILABLE...  ...and performance-driven Physician Medical Billers to join...  ...accurate and timely billing, claims management, and accounts...  ...Prepare, review, and submit medical claims...  ...of service, diagnosis codes (ICD-10), procedure codes... 
    Remote work
    Claims
    Hourly pay
    Full time
    Part time
    Work at office
    Relocation package
    Shift work
    Afternoon shift

    POM Recoveries

    Farmingdale, NY
    3 days ago
  • Physician Advisor - UM MSQ Location: St Josephs Main and Childrens Status: Part...  ...Work: None On Call: No Remote Work: Hybrid Equal Opportunity...  ...management and utilization review departments and the hospital...  ...regulations, appropriate physician coding and documentation... 
    Remote work
    Part time
    Shift work
    Weekend work

    BayCare Health System

    Tampa, FL
    11 hours ago
  •  ...PRN Physician Coding Specialist II, Orthopedic Clinic - Sheffield Village...  ...timely payments of outstanding claims. What You Will Do:...  ...departmental guidelines. Reviews and corrects coding edits and...  ...Entry Level Travel: No Remote Work: Hybrid Job Posting:... 
    Remote work
    Claims
    Daily paid
    Work experience placement
    Relief

    University Hospitals

    Sheffield Lake, OH
    2 days ago
  •  ...the Mission and Guiding Behaviors; the Physician Coding Specialist II will assign the appropriate...  ...for data retrieval, analysis and claims processing for the Mount Carmel Medical...  ...interdisciplinary care delivery system. Reviews and evaluates patient medical records to... 
    Remote job
    Claims
    Full time
    Work experience placement
    Work at office
    Local area
    Shift work

    Trinity Health

    Columbus, OH
    1 day ago
  •  ...Neurosurgeon, Neurologist, and Physical Medicine & Rehabilitation physician to process utilization reviews. Work's Compensation experience is preferred but not...  ...clinical expertise, and reviews workers' compensation claims by providing an interpretation of the medical... 
    Remote work
    Claims
    For contractors
    Monday to Friday

    Dane Street

    Washington DC
    1 day ago
  •  ...Assistant II (Hybrid) - Physician Billing...  ...insurance records, and claims, contacting insurance companies...  ...of physician charges.* Reviews patient accounts to verify...  ...environment.* Primarily remote with the exception of coming...  ...), ICD-10 Procedure Coding System, Insurance Follow... 
    Remote work
    Claims
    Work experience placement
    Work at office

    Washington University

    Saint Louis, MO
    1 day ago
  • $85k - $90k

     ...Cost Outlier, and Readmission Reviews.  Under the direction of...  ...reviews of inpatient claims to ensure coding accuracy and appropriate DRG...  ...diagnoses.  This is a fully remote position. Candidates must be...  .... Collaborates with physician reviewers, as needed. Ability... 
    Remote work
    Claims
    Full time

    MedReview

    New York, NY
    a month ago
  • $204.76k - $292.52k

     ...need great people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties...  ...please click HERE Current Contingent Worker please see job aid HERE to apply #LI-Remote
    Remote work
    Hourly pay
    Full time
    Relief
    Work at office
    Local area

    ChenMed

    Miami, FL
    11 hours ago
  •  ...Summary The DRG Validator/Reviewer is responsible for reviewing post-billed inpatient claims to identify and validate missed...  ...based on diagnosis and procedure coding. Working within a specialized...  ...role is primarily office-based or remote, depending on company policy,... 
    Remote work
    Claims
    Full time

    EnableComp

    Remote
    17 days ago
  •  ...Summary The DRG Validator/Reviewer is responsible for reviewing post-billed inpatient claims to identify and validate missed...  ...based on diagnosis and procedure coding. Working within a specialized...  ...role is primarily office-based or remote, depending on company policy,... 
    Remote work
    Claims
    Full time

    EnableComp

    Remote
    10 days ago
  • ChenMed is seeking a Physician Reviewer to lead utilization management reviews and advise fellow physicians. The role includes coordinating care...  ...plans and local teams, participating in QA and delegated UM processes, and supporting territory-based case development. Strong... 
    Remote job
    Local area

    ChenMed

    Miami, FL
    11 hours ago
  •  ...for the organization under the Director of Coding and Billing. The role emphasizes patient-...  ...team environment. Position may be remote eligible for the right candidate, with a...  ...on accuracy and efficiency in processing claims and communicating with patients about balances... 
    Remote work
    Claims
    Full time

    Horizon Health Care Inc

    Howard, SD
    4 days ago
  •  ...This need will be FULLY remote while the provider is...  ...Responsibilities: ~ Reviews prior authorization and...  ...approval or denial of claims payment based on...  ...define acceptability of physician performance, conducts review...  ...Participation in a managed care UM committee - PREFERRED... 
    Remote work
    Claims
    Permanent employment
    Locum
    Local area
    Weekend work

    Med Ninjas

    Dallas, TX
    4 days ago
  • $248.5k - $373k

     ...together.As part of the Focus Claims Review team at Optum, the Medical...  ...development and implementation of coding and procedures.You'll enjoy the flexibility to work remotely * from anywhere within the U....  ...other colleagues including physicians, nurses, PTs, OTs and other... 
    Remote work
    Claims
    Minimum wage
    Full time
    Work experience placement
    Local area
    Monday to Friday
    Flexible hours

    UnitedHealth Group

    Los Angeles, CA
    2 days ago
  •  ...position may transition to a hybrid remote work arrangement (three days...  ...AR procedures, including reviewing aging reports, denials, and...  ...experience in medical billing, coding, and claims-related services. ~ Previous experience in physician office and/or hospital... 
    Remote work
    Claims
    Contract work
    Work at office
    Monday to Friday
    3 days per week

    Evenflow Solutions

    Frisco, TX
    4 days ago
  • $240k

     ...Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation...  ...perform medical necessity reviews, peer-to-peer discussions,...  ...-auths, concurrent reviews, claims, and appeals Make medical...  ...to-peer reviews and support UM staff Participate in committees... 
    Remote job
    Claims
    Full time
    Relocation

    HealthPlus Staffing

    Daytona Beach, FL
    1 hour ago
  •  ...Working remotely, the full-time State Licensed Utilization Reviewer will perform utilization reviews on workers' compensation treatment referrals, ensuring the...  ...medical treatment plans and contributing to effective claims management. Key responsibilities Utilizes... 
    Remote work
    Claims
    Full time

    Virtual Vocations Inc

    United States
    3 days ago
  •  ...organization as directed by the Director of Coding and Billing. Successful candidates for...  ...wellness of our communities. Position may be remote eligible for the right candidate. Key...  ...insurance activity; follow-up on problem claims. Prepare and submit monthly patient... 
    Remote work
    Claims
    Full time

    Horizon Health Care Inc

    Howard, SD
    11 hours ago
  • $7.5k

     ...Nurse - Utilization Mgmt Reviewer - Case Management -...  ...Utilization Management (UM) Reviewer, in collaboration...  ...Clinic offices, other physician offices, and the Robert...  ...generation of clean claims in a timely manner Securing...  ...with CPT/ICD coding, medical record or chart... 
    Claims
    Full time
    Work at office
    Relocation package
    Shift work

    Guthrie Enterprise

    Slab, NY
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Physician ED Claims Reviewer (UM & Coding). Be the first to apply!